Neck Imaging Guidelines

This policy covers imaging of the neck—including plain radiography, soft‑tissue ultrasound, CT and MRI—for evaluation of anatomy from the upper oral cavity/skull base to the head of the clavicle (parotid and other salivary glands, lymph nodes, thyroid/parathyroid, trachea/bronchus, and carotid/cerebrovascular structures). It applies to patients with suspected cerebrovascular/carotid disease, dysphagia/esophageal disorders, cervical lymphadenopathy, neck masses or malignancy, recurrent laryngeal palsy, thyroid/parathyroid and salivary gland disorders, and neck pain. Advanced imaging is only covered after a documented clinical evaluation within 60 days (history/physical, relevant labs and prior non‑advanced imaging such as x‑ray or ultrasound), atypical presentations require physician review, MRI is reserved for specific indications, and routine CT with both noncontrast and contrast is generally discouraged due to limited incremental benefit and added radiation/contrast impacts.